Cross-border travel patterns affect magnitude estimates for the Ebola Bundibugyo epidemic

This research examines how geographic spread approaches can be adapted to account for the specific travel patterns and epidemiological context of the DRC–Uganda border. The 2026 Bundibugyo virus disease epidemic in the Democratic Republic of the Congo highlights the challenges of estimating disease burden when cases are detected across an international border. A geographic spread approach is often used to estimate the true burden of infectious disease cases in a source population by leveraging statistical signals generated by cases exported and reported elsewhere.

The analysis demonstrates the importance of allowing for key epidemiological contexts when using a geographic spread approach to avoid potentially biasing estimates that are critical to inform early epidemic responses. While the method is appealingly simple and intuitive, its reliability and generalizability depend on a careful consideration of these real-world contexts.